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Home My WebLink AboutBLDE-21-003785 Commonwealth of Official Use Only f�. :14\ Massachusetts Permit No. BLDE-21-003785 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked — [Rev.1/07] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:1/7/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. f !S Location(Street&Number) 106 CAPT YORK RD 4Q8 :�'2 `�-a7`7 2 Owner or Tenant Gary McFarland Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wiring for exterior shed. Completion of the following table may be waived by the Inspector of Wires': No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above No.of Luminaires Swimming Pool ❑ grnd. ❑ No.of m•'ts 1 L rig / BatNo.of Receptacle Outlets 4 No.of Oil Burners FIR A' r I (I. P2 No.of Switches 1 No.of Gas Burners No.of De o n • .0 Initiating De • �� Z No.of Ranges No.of Air Cond. Total No.of Alerting Devi Q Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ • i Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjuty,that the information on this application is true and complete. FIRM NAME: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 �,c ( //u 4(4 ` CEO� C ,•. � ril '� cc77i Permit No. �' 1►�`0'-• • �tparfnirnl o`,tnr�awtul Occupancy and Fee - k ._ r Ale MENT BOARD OF FIRE PREVENTION REGULATIONS ' V. l/07) leaveIA ,, BU1�_U1/4C -- - • APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 151 ao a I City or Town of: tdia►'i'l4 0 AA'-1 To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) I O (p (L p-I-61 i c (-lf 16 Owner or Tenant Caik rn(°5F air la/401 Telephone No.9) -C (/1-- (2?? Owner's Address 1 D(j' - -t i n "r)YIL Is this permit in conjunction with a permit? Yes 0 No ® (Check Appropriate Box) Purpose of Building `j i-ve CI Utility Authorization No. Existing Service 1 00 Amps / ' DVolts Overhead❑ Undgrd❑ No.of Meters I New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity ^,� € Location and Nature of Proposed Electrical Work: (,()l v-1 n t� 6 U�S i U e s h e d Completion of the followinktable my be waived by the Insyector of Wires. No.of Recessed Luminaires No.of Cal.-Susp.(Paddle)Fans To.of � Total Transformers KVA CANo.of Luminaire Outlets No.of Hot Tubs Generators KVA n A- No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Units Lighting and. Erna. Battery Units eF No.of Receptacle Outlets I No.of Oil Burners FIRE ALARMS No.of Zones Detection and No.of Switches I I No.of Gas Burners No.ofl nitiaftng Devices ' No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Totals: Pump Number Tons KW No.of Self-Contained Totals: �' Detection/A��Devicea No.of Dishwashers Space/Area Heating KW Local 0 C naection 0 Other No.of Dryers Heating Appliances KW SecNa ofSZ or Equivalent No.of Water No.of No.of Data Heaters ' Sys Ballasts No.of Devices or Equivalent No.Hydrossassage Bathtubs No.of Motors Total HP TelecommunicationsfDevices r R� Na of Devices or Eq t OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: S W (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND 0 OTHER 0 (Specify:) I ce,Wfy,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: cut, akt�Cl1d Signature g M 9- ,(. LIC.NO.: R-3gQ S (If applicable,enter exempt"in the license=ins /`) // Bus.Tel.No.: Address: Lb(D'exempt.; /LO J-It viW, Ale.Tel.No.: •Per M.G.L.c. 147,s.57-61,security wires Department of gPuubblic Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally requiyed_by law. B my signature below,I hereby waive this requirement. I am the(check one ❑owner ❑p ter's a ent. ix--(via